Full Text
Columbia Judicial Circuit Felony Accountability Court Programs Referral Form Honorable James G. Blanchard, Jr. Senior Judge, Superior Court Accountability Courts Program Rhoda Kimble-Wheeler, Coordinator Columbia Judicial Circuit Telephone: (706) 447-6761 Fax: (706) 321-7437 (SECTION IV MUST BE ANSWERED FOR CONSIDERATION) Program of Interest: ☐ Drug Court (traditional track - nolle prossed) ☐ Behavioral Health Treatment Court ☐ Veteran’s Treatment Court ☐ Probation Drug Court Track Date: Defendant’s Name Date of Birth Social Security Number - - Gender Race Referral Source/Attorney: Phone Number Physical Location of Defendant for Contact: Incarcerated ☐ County Bonded ☐ ( ) Street Address City, State Zip Code Phone Number What is the physical address where the Defendant will live, if accepted into the program? Physical Address City, State II. CURRENT CHARGES Date of Charge Pending Case Number Type of Charge III. PRIOR CHARGES Date of Charge Case Number Type of Charge I. DEFENDANT INFO ---PAGE BREAK--- 1. Is the District Attorney’s Office in agreement with the Defendant applying and entering the Probation Drug Court Track? ☐ Yes ☐ No 2. Has Defendant been found ineligible for Traditional Drug Court? ☐ Yes ☐ No 3. Is the presiding judge aware of your application to the Probation Drug Court Track? ☐ Yes ☐ No 1. Does the Defendant have a mental health diagnosis? ☐ Yes ☐ No a. If so, please provide proof of diagnosis from treating doctor or facility (mental health records will be requested, if client is found eligible) 2. Has the Defendant ever been hospitalized for mental health and/or substance use disorder? ☐ Yes ☐ No a. If so, please provide proof of services from the facility (additional records will be requested, if client is found eligible) 3. Is this a transfer case request? ☐ Yes ☐ No a. If yes, please include the entire file with the application to include the original charge and discovery. 4. Is the Defendant a Veteran? ☐ Yes ☐ No a. If so please include proof of Veteran status, i.e. DD214. For consideration, please complete and email to: Attention: Mr. Hunter Alexander, Assistant Public Defender Email: [EMAIL REDACTED] Please also copy the following individuals: Mrs. Rhoda Kimble-Wheeler, Accountability Courts Coordinator Email: [EMAIL REDACTED] Mrs. Betty Johnson, Accountability Courts Case Manager Email: [EMAIL REDACTED] IV. PROBATION TRACK QUESTIONS (not available at this time) V. RECORDS REQUEST